The World Health Organisation estimates that 92 per cent of the world’s population live in areas with inadequate outdoor air quality, and this pollution contributes to one out of every eight deaths. FILE PIC

WE intuitively know that poor air quality is bad for our lungs, but the situation is probably far worse than what most of us imagined it to be. Poor quality goes so much more beyond irritating the airways and making us cough. Air pollution kills.

An air pollutant is any substance in the air that can adversely affect humans and the natural environment. Although some may be natural in origin, most are man-made. These include carbon monoxide from motor vehicle exhaust and sulphur dioxide from factories.

PM2.5 is of particular interest; its readings are often included in reports on air pollution. It refers to atmospheric particulate matter (PM) that have a diameter less than 2.5 micrometers, which is less than five per cent the diameter of a human hair. These fine particles can come from vehicles, power plants, forest fires and agricultural burning. Given their size and lightness, they tend to stay in the air for a longer duration, thus, increasing the risk for human inhalation.

This is of great importance as hundreds of scientific papers have been published, showing a link between PM2.5 and poor health outcomes. High levels can lead to heart diseases and asthma, especially among those who are particularly susceptible, such as children and the elderly.

A recent study in the New England Journal of Medicine looked at a population of 60 million over a period of 12 years and concluded that for every increase of 10g per cubic meter in PM2.5, there was an associated 7.3 per cent increase in all-cause mortality. There was no appreciable level below, which the risk of death tapered off — and thus, no “safe” level of PM2.5.

Worryingly, the Forum of International Respiratory Societies recently warned of a new potential air pollution health hazard associated with burning coal. The burning of coal leads to the production of ultrafine particles called titanium suboxide. Just like other forms of fine and ultrafine particulates, these can float away from coal power plant stacks and travel with air currents over long distances.

An article published in Nature Communications reported that these ultrafine particles were found on city streets and sidewalks in Shanghai. When inhaled into the lungs, the ultrafine particles can make their way into the bloodstream in a manner similar to other forms of fine particulate matter.

China has noted a significant hike in respiratory-related diseases as a result of its poor air quality. This includes an increase in the number of lung cancer cases in non-smokers and younger patients. It is unsurprising that China has taken great efforts to alter its energy and environmental policies to the point that it has filled in the vacuum created by United States President Donald Trump’s recalcitrance to sign the Paris Climate Agreement.

Malaysia too, has taken steps to address environmental issues, including the novel Green Sukuk that was launched earlier this year. This first-of- its-kind Islamic bond will see proceeds used to fund specific environmentally sustainable infrastructure projects and was created with the assistance of the World Bank.

Unfortunately, there are other policies in place that are not as environmentally-friendly, including the plan to increase the proportion of coal in Malaysia’s energy mix. Although it may be cheaper on paper, it is worth noting that the burning of coal has significant adverse effects on the quality of outdoor and indoor air. The World Health Organisation estimates that 92 per cent of the world’s population live in areas with inadequate outdoor air quality, and this pollution contributes to one out of every eight deaths.

It is high time we switch to an energy policy that minimises the role of the biggest driver of global warming. Coal has had its day, and although it still has a role to play, there should be a greater push for the use of cleaner energy, such as gas and renewable sources of fuel.

Dr Helmy Haja Mydin is a respiratory physician and co-founder of Asthma Malaysia, an organisation dedicated to patient education and empowerment

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